Everyday Heroes

Name*
First Last
Your Email*
Name of Everyday Hero Nominee*
First Last
Email of Nominee*
Where does this Everyday Hero live?*
City State / Province / Region
What makes this person an Everyday Hero?*
I grant permission to Forever Media, Inc. to use my name, likeness, and biographical data, in whole or in part, in any and all media, for the purpose of advertising, publicity, and trade, and in connection therewith, I hereby release each of them from any and all liability. I agree to the use of my name and likeness for such purposes without limitation and without any compensation whatsoever, except where prohibited by law.*
- I agree to the above.